Over the past 20 years numerous studies in the South Pacific islands have been able to document changes associated with the epidemiologic transition where decreased infant mortality, and increased life expectancy, are economic development has resulted in and the adoption of a "western lifestyle" in place of more traditional pattern of living. For minority populations in the United States, the association of improving socioeconomic status and accompanying changes in lifestyle with increasing rate of NIDDM has not been well documented, particularly for African Americans. The dramatic three-fold increase in NIDDM prevalence among African-Americans over the past 25 years suggest a need to address this issue in the U.S. Black population. Unfortunately, there are currently no longitudinal studies of diabetes in African-Americans. The proposed four year project is developed to address this issue by conducting a population-based study to assess the prevalence of NIDDM in the U.S. Virgin Islands (U.S.V.I.), a predominantly African-American population that is currently at a stage in the epidemiologic transition where the prevalence of diabetes (3.5%) is intermediate between low rates in Black Africans (1%) and higher rates in U.S. African-Americans (5.3%). The study is designed to test the hypothesis that the of NIDDM is lower among African-Americans in the U.S.V.I than among those on the U.S. mainland. Data on physical activity, and other lifestyle associated factors will be collected by personal interview. Blood chemistries for glucose, glycosylated hemoglobin, serum lipids/lipoproteins, C-peptides and insulin will also be performed. The cohort established will be followed prospectively to evaluate how changes in lifestyle factors such as, diet, obesity, and physical activity influence changing rates of NIDDM. This data will be important for development of effective prevention an intervention efforts to lower the risk of developing NIDDM in the African-American community.